. "7 Increasing Workforce Capacity for Quality Improvement." Improving the Quality of Health Care for Mental and Substance-Use Conditions: Quality Chasm Series. Washington, DC: The National Academies Press, 2006.
The following HTML text is provided to enhance online
readability. Many aspects of typography translate only awkwardly to HTML.
Please use the page image
as the authoritative form to ensure accuracy.
Improving the Quality of Health Care for Mental and Substance-Use Conditions
Continuing education focuses on refining existing and developing new skills, as well as mastering changes in the knowledge base and treatment approaches. Unlike preservice education, which is organized around a formal curriculum, continuing education is commonly self-directed by the practitioner, who selects areas of interest to pursue (Daniels and Walter, 2002).
Few standards or guidelines govern the continuing education content that providers choose to study. Continuing education requirements are set principally by licensing and certification bodies, many of which are controlled by the states. These requirements are generally nonspecific, outlining only the number of hours of continuing education that must be completed during a specified number of years in order to maintain licensure or certification. While some states and disciplines mandate continuing education in specific content areas, such as professional ethics (Daniels and Walter, 2002), “the general absence of standards or guidelines regarding content raises concern that many practitioners may never become educated about critical, emerging issues in the field, such as patient safety” (Morris et al., 2004:18), illness self-management (see Chapter 3), or the Chronic Care Model (see Chapter 5).
A 2001 survey of the continuing education requirements for M/SU disciplines set by the states for licensure renewal found a striking lack of consistency in the requirements for a given professional discipline across states, as well as in the requirements for different mental health disciplines within states. The requirements for psychologists, for example, range from zero hours of continuing education (11 states), to 12 hours per year (Alabama), to 50 hours per year (Kansas) (Daniels and Walter, 2002).
As usually provided (i.e., in single-session events such as conferences, lectures, workshops, and dissemination of written materials), continuing education has been found to have little effect in changing clinical practice (Davis et al., 1999). Teaching adult learners clearly requires different approaches; moreover, research has shown that not everyone learns the same way. While many individuals learn well through reading, for example, others learn better through approaches that allow them to use their motor skills. Clinicians also can benefit from being taught individually, rather than in a group, at a pace suited to their particular learning style (Lazear, 1991). Empirical support exists as well for education strategies such as interactive sessions (role playing, discussion groups, and experiential problem solving); academic detailing, in which trained experts meet with providers in their practice setting; audit and feedback (Morris et al., 2004); use